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This certification course is in powerful require by the world’s giant organization to help the trade requirement. TOGAF 9.2 certification is a course which includes the basic and ground principles of Enterprise Architecture. Here is a brief of what is taught in this certification course:

Guidelines For Defining Enterprise Architecture

For the future success of a business, there are some very basic things that a person should know. For this, Enterprise Architecture plays an extremely faultfinding role. By taking the TOGAF 9.2 certification course, the practitioner will breathe fully capable of serving any organization.

For instance, trade processes relish how a specific trade works, the meaning, and explanation of outright types of charts that are used in the business, networks concept diagrams, etc., are clearly and thoroughly explained to the learner. This is done to merit the practitioner fully-fledged with outright the requirements that are needed in this realm.

IT Alignment

Every IT organization has goals and strategies. To achieve those goals should breathe aligned in a manner that efficacious results for those should breathe obtained. This is the basic acceptation of IT alignment and Enterprise Architecture covers this territory in a broad manner. The main reason for this is that each and every industry works only and only to achieve some goals. To achieve them, the workers should know how to implement the strategies using them effectively. Therefore, the TOGAF 9.2 certification caters to it very effectively.

Efficient IT operations in short means using resources that are available in the fashion which brings profits and height to the organization. There are some ways that are needed to breathe taught to the people working in these organizations and then only they can exhaust the available resources in the profitable and the best-suited manner. For example, if the organization is going through a monetary crisis, the employees working in this region should know how to control the pecuniary head to support the company at such times. Such skills are taught and then the only employee can work making sure that they are supporting the company in the best manner. These things cannot breathe implemented without the learning and TOGAF 9.2 provides this knowledge.

Why is it faultfinding to elevate up TOGAF 9.2 Certification?

For people who are into Enterprise Architecture, TOGAF 9.2 Certification is one of the most faultfinding things to learn. This is because people who absorb done this certification course absorb higher chances to breathe approached by reputed companies outright over the world. Here, the professionals are not limited to proprietary methods but are able to learn and grow more. They are given the license to choose the sources in a most efficacious manner which helps to net the best in recur investment. To net a job and sustain in the industry, professional should know how enterprise architecture can enhance the current capabilities and aid in synchronization with whatever novel requirements advance up in the field.

Every organization has its own set of requirements in the territory of Enterprise Architecture and this certification course is designed in such a way that it fully helps the professional to cater to those specific needs. The practitioner here learns the novel practices and the trends which are necessary for Enterprise Architecture and this helps them to understand the whole subject in a better manner.

Written by Andrew Josey, Director of Certification, The Open Group
Published: 28 June 2006

Page 2 of 2

The TOGAF Architecture development fashion therefore does not prescribe any specific set of enterprise architecture deliverables - although it does report a set, by way of example. Rather, TOGAF is designed to breathe used with whatever set of deliverables the architect feels is most arrogate for their business. That may breathe the set of deliverables described in TOGAF itself; or it may breathe the set associated with another framework, such as Zachman Framework or FEAF, for example.

TOGAF is not intended to compete with these other frameworks. Rather, it is intended to accomplish a unique role, in distilling what these other frameworks absorb to offer, and providing a generic Architecture development fashion that can breathe adapted for exhaust with any of these other frameworks.

The Open Group's vision for TOGAF is as a vehicle and repository for practical, experience-based information on how to travel about the process of enterprise architecture, providing an open fashion with which specific sets of deliverables, specific reference models, and other germane architectural assets, can breathe integrated.

The Open Group's latest edition of TOGAF is version 8.1. The Open Group introduced the TOGAF 8 certification program in order to ensure the consistent application and usage of TOGAF throughout the industry, and protect the value of TOGAF to its users. This assurance program provides four classes of certification: Certified (for individual practitioners), Tool Support, Training and Professional Services. It is used by architecture service providers, tool vendors and individual enterprise architects.

For service providers and tool vendors, the certification provides a vehicle to clearly demonstrate that their services and products support and exhaust the TOGAF methodology. Organizations can absorb their products (TOGAF Tools or Training Courses), and services certified by meeting the criteria specified in the arrogate Product Standard.

Individuals can become certified by demonstrating their learning of TOGAF either by attending a training course or passing an examination test. To date, more than 1,200 practitioners absorb been TOGAF 8 certified, which speaks volumes about IT Architecture as a well-recognized and increasingly faultfinding professional discipline.

With TOGAF, customers can groundwork their IT architecture on an open, industry standard method, which works with outright major frameworks and can procure tools, training and the services of consultants (individuals and integrators) with confidence on the basis of certified conformance with an open consensus standard.

To find out more about the TOGAF 8 certification program, tickle visit The Open Group web site.

The completion of the Human Genome Project in 2003 led to an explosion of potential for applying genetics and genomics into health care. The expanding availability of genomic information highlights the role genetics plays in outright aspects of health across the lifespan, from preconception genetic counseling to cancer treatment (Rehm, 2017). Genetics is the study of single gene composition, function, and heredity; genomics considers the interaction of outright genes within the genome and their combined influences on patterns of development and pathologic consistencies (Hillman & Dale, 2017). The focus of genomics in health care is now transitioning from diagnosing single-gene rare conditions to identifying risk factors for and patterns within more prevalent conditions such as diabetes, obesity, asthma, cancers, and mental health conditions (Feero & Guttmacher, 2014). The purpose of this article is to review the growing significance of genetics and genomics in primary care delivery, argue the challenges of genetic and genomic competence in nurse practitioner (NP) education, and showcase one strategy for student learning and competence. The two terms, genetics and genomics, are used throughout the article because both are germane to the discussion and both terms show frequently in the nursing education resources on the topic (American Association of Colleges of Nursing, 2013; Greco, Tinley, & Seibert, 2011).

As researchers better understand the interaction among environmental, behavioral, and genetic factors in determining health risks and outcomes, health care must evolve to further integrate genomic concepts in individualized care and gallop toward precision medicine (Rehm, 2017). Precision medicine is an approach to care that considers individual variability in the genes, environment, and lifestyle of each person (National Institutes of Health, 2015). Early identification of genetic variables in patient conditions allows more specific anticipatory guidance, monitoring, screening, and better prioritization of treatment options (Aronson & Rehm, 2015). At least 10% of patients seen in primary care may absorb a condition with a genetic contribution; this percentage is expected to multiply with continued research (Paneque et al., 2016). A systematic review of admissions to a children's hospital in 1 year revealed 71% had a disorder with a genetic determinant and 96% of admissions due to chronic disorders had a genetic etiology (Francescatto & Katsanis, 2015). As the role of genetics grows in both preventive and diagnostic care, primary care clinicians, including NPs, are in a prime position to apply genetic understanding for earlier diagnosis and intervention to ultimately help patient outcomes (Rinke et al., 2014). To provide cutting-edge care, clinicians must learn to incorporate genomic principles in patient encounters, transitioning from considering genetics as solely rare genetic diseases to examining the role genetic factors play in outright aspects of health (Feero & Guttmacher, 2014). Some experts are encouraging outright primary care providers to integrate genetic thinking when encountering outright patients (Scott & Trotter, 2013).

More than 50,000 genetic tests are already in exhaust across the world and approximately 10 novel testing products consisting of single gene and panel tests are developed every day (Concert Genetics, 2017). Newborn screening, widely used by pediatric practitioners, is an application of genetic testing performed on asymptomatic infants to detect congenital diseases prior to detrimental sequelae, allowing early intervention to reduce morbidity and mortality (Francescatto & Katsanis, 2015). Since its introduction in the 1960s for the detection of phenylketonuria, the recommended universal newborn screen has snowballed and currently includes 34 core and 26 secondary disorders; newborn screening is one of the largest and most successful disease prevention systems (NewSTEPs, n.d.). Recent progress in genomics research has allowed novel genetic testing and application, including diagnostic and carrier testing for inherited conditions, presymptomatic and predictive testing for individuals with genetic susceptibility disorders, risk factors for later onset conditions, and biomarkers that guide individual treatments (Francescatto & Katsanis, 2015; Larson & Wilke, 2015). Testing has generally become less expensive, faster, and more sensitive (Rehm, 2017). The vast majority of variants identified absorb unknown significance; however, the data sharing on databases allows more accurate interpretation of variants to pave the way for novel diagnostic markers of disease and precision medicine (Rehm, 2017).

As exciting as these developments are, the pace of innovation is outstripping optimal integration into primary care rehearse (Rehm, 2017). Both the common public and health care providers absorb limited genetic literacy, and implementation of novel genetic applications in primary care are substandard (Arora et al., 2017). The past focus of genetics on rare diseases makes it difficult for primary care providers to understand the relevance of genetics and genomics in everyday rehearse (Saul, Trotter, Sease, & Tarini, 2017). In a recent survey of primary care providers, less than 10% ordered genetic tests for patients they identified as at risk and instead referred to a genetic specialist. Identified barriers were lacking confidence in interpreting and explaining genetic test results, insufficient training identifying genetic risks and choosing arrogate tests, and absence of guidelines for management (Saul et al., 2017). Similarly, primary care NPs reported insufficient learning regarding genetics and risk assessment, overall want of genetic resources, and time as barriers (Mikat-Stevens, Larson, & Tarini, 2014; Seibert, 2014).

Practice standards and competencies guide outright aspects of advanced rehearse nursing by outlining essential behaviors outright NPs must accomplish proficiently. Professional organizations recognize the weight of integrating genetics and genomics into advanced rehearse nursing, which is reflected in the current competencies. In 2004, the National Human Genome Research Institute and the National Cancer Institute initiated the compilation of nursing competencies for genetics after identifying the pressing requisite for its broad understanding among oncology nurses. The project expanded to define essential genetic and genomic competencies for outright nurses, regardless of academic preparation, role, or clinical specialty (Eggert, 2017). The competencies were crafted by an independent panel of nurse leaders from clinical, research, and academic settings and were endorsed by 48 nursing organizations before publication by the American Nurses Association in 2006 (Kelly, 2009). In 2011, the American Nurses Association published Essential Genetic and Genomic Competencies for Nurses With Graduate Degrees (Greco, Tinley, & Seibert, 2011). Included are 38 competencies in seven categories: risk assessment and interpretation; genetic education, counseling, testing, and results interpretation; clinical management; ethical, legal, and social implications; professional role; leadership; and research (Greco et al., 2011). Population-Focused Nurse Practitioner Competencies, developed by the National Organization of Nurse Practitioner Faculties in 2013, specified genetic competencies for primary pediatric, family, neonatal, and women's health NPs (American Association of Colleges of Nursing, 2013).

For advanced rehearse nurses (APNs) in primary care, genetic and genomic competency includes risk assessment and test interpretation, requiring a complete history and physical and a comprehensive family health history, a powerful tool for assessing risks for Mendelian and multifactorial genetic disorders (Greco et al., 2011). The family history is considered by some genetics educators as the most powerful initial genetic “test” (Scott & Trotter, 2013). APNs must breathe proficient in identifying faultfinding findings in the family health history to aid identify individuals and families at higher risk for genetic conditions. APNs must breathe able to define findings from the family history, physical assessment, and diagnostic and laboratory tests to patients and families then merit arrogate referrals (Greco et al., 2011). This is faultfinding because provision of incomplete information can breathe detrimental to patient outcomes (Whitt, Hughes, Hopkins, & Maradiegue, 2016).

Although assimilating genetic and genomic principles into primary care is recognized, it is unclear how clinicians can best meet these standards (Hillman & Dale, 2017). One strategy is for clinicians to work frequently with genetic teams to continuously update their learning (Hillman & Dale, 2017), which is not feasible for most clinicians. The American Academy of Pediatrics trait Improvement Innovation Networks studied the effectiveness of a continuing education intervention with 13 pediatric practices using regular educational opportunities, access to genetic professionals, and performance feedback (Rinke et al., 2016). This multifaceted approach resulted in sustained improvement in the inclusion of genetic and genomic behaviors. Another study reported on a 15-week online graduate NP genetics course covering basic genetic knowledge, ordering genetic tests, predicting genetic risk, collecting family health history, discussing genetic diagnoses, and using genetic resources (Whitt, Macri, O'Brien, & Wright, 2016). Students were significantly increasing their learning of basic genetic topics, conditions, and inheritance patterns and were more confident applying genetic skills in practice. A systematic review of genomic training for nongenetics health professionals showed only four of 44 studies reporting statistically significant changes in rehearse behavior (Talwar, Tseng, Foster, Xu, & Chen, 2016). Focusing on changing primary care providers' awareness of genetics, enhancing their faculty to find germane information, and training students to develop a framework for incorporation of genetics may breathe an efficacious approach to increasing genetic and genomic competency for primary care providers (Kemper et al., 2010; Paneque et al., 2016).

Method

The following case study demonstrates how genetic and genomic competencies were scholarly in a primary care pediatric nurse practitioner. Three pediatric nurse practitioner students, one per semester, completed an elective rotation in pediatric genetics as fragment of the Masters of Science in Nursing program at a large university in the United States. This elective rotation was through the associated hospital's Institute of Genetic Medicine. The institute provides outpatient services to those with a wide scope of common and subspecialty genetics indications, and the rotation consisted of a weekly 8-hour clinic. The learning taste was interprofessional and included interaction with a variety of other learners, including medical, genetic counseling, graduate genetics students, pediatric residents, and medical genetics fellows. outright trainees were supervised by a coalesce of pediatricians, geneticists, and certified genetic counselors. Prior to each weekly clinic, students were assigned specific patients to research and review unfamiliar conditions. The NP preceptor, a pediatrician, and a geneticist encouraged trainees in genetic thinking, where the learners approach each patient and family comprehensively regarding genetics. The preceptor provided germane articles to the students, and students scholarly to access national genetic resources to foster their individual learning.

Students provided initial evaluation and follow-up care for patients with a wide variety of conditions, such as Ehlers-Danlos syndrome, partial androgen insensitivity, sagittal synostosis, and hearing loss. The goal of the rotation was not to gain a complete overview of the many conditions with a genetic component, but rather to develop an understanding of the best approach to identify and manage a genetic problem and gain familiarity with some common conditions. Accordingly, the rotations emphasized the weight of collecting germane information by performing a thorough family history and learning where to collect accurate information related to genetic conditions. Students were encouraged to investigate presenting symptoms and congenital anomalies of various patients through online resources, such as Online Mendelian Inheritance in Man® database, GeneReviews®, Genetics Home Reference®, and the American College of Medical Genetics™. To gain self-sufficiency and applicable skills for primary care practice, students used these resources for investigating both identified genetic conditions and to develop differential diagnoses for seemingly unrelated findings.

Regarding evaluation, at the discontinuance of each semester, NP students complete evaluations of their clinical learning and faculty review these evaluations to better understand student learning potential and to determine the best future exhaust of each site. Regarding these three NP students with rotations at the Institute of Genetic Medicine, the NP preceptor (pediatrician and geneticist) and pediatric nurse practitioner faculty track coordinator had additional discussions with each student to further understand their learning and experiences at the specialty site and to adjust the taste for future students accordingly.

Results

Throughout the clinical rotation, students perfected the skill of completing a patient's pedigree by collecting a three-generational family health history. This reinforced their focus on creating a comprehensive picture to assist in identifying genetic red flags. Each family health history included questions related to consanguinity or proximate biological relationships between family members, history of multiple miscarriages, known genetic conditions or testing results, congenital anomalies, sudden unexplained death at a young age, intellectual or learning disabilities, multiple family members with similar or related disorders, and the ethnic background of the family. Student learning assignments related to the clinical taste included writing case studies with differential diagnoses, class presentations, and personal and professional recordings and reflections in a clinical log.

Through exposure to multiple genetic consultations, the students gained an understanding of foundational skills for incorporating genetics and genomics into primary care practice. Solidifying assessment skills strengthened the students' confidence in evaluating genetic contributions to health and disease. They likewise scholarly where to access genetics resources and clinical tools for future patients. The most salient component of the rotation was the shift in students' awareness of where and when to apply genetic thinking to identify risk factors in outright patients and families, allowing more precise recommendations for better individual health. Through gaining an in-depth understanding of the faultfinding role genomics plays in the pediatric primary care population and consistently performing risk assessments in the forms of individual history and physical and three-generational family history, students were more competent to care for their future patients and families.

Discussion and Conclusion

Primary care NPs must learn to integrate genetic thinking in outright patient encounters, thereby routinely incorporating genetics and genomics into their clinical rehearse to meet the standards outlined by current APN competencies. Despite of many barriers, two specific objectives could breathe targeted to help genetics confidence and application. First, NPs must breathe competent in collecting a family health history, and second, NPs must absorb a thorough understanding of genetic resources. Although primary care practitioners state that they understand the weight of assessing a patient's risk factors for a given disease, especially the weight of taking a family health history, less than one third of practitioners actually collect a three-generational family health history for outright patients (Rinke et al., 2014; Saul et al., 2017). More than half of practitioners did not absorb adequate resources to determine the arrogate genetic test to order and almost half were not conscious of a national resource to provide them with accurate genetic information and services (Rinke et al., 2014). Both of these objectives, collecting a family health history with a specific understanding of assessing for genetic red flags and having a comprehensive understanding of available genetic resources, can breathe easily incorporated into training for NPs, as demonstrated in the case study presented.

In summary, the inclusion of a genetics clinical rotation in a primary care NP graduate program provides an excellent occasion for NP students to assimilate emerging genetic recommendations into practice. By practicing foundational skills for risk assessment and information gathering in an environment where genetic specialists are at hand to guide education, NP students develop genetic thinking that will ultimately help the care they provide to patients. If NPs are to provide optimal primary care by incorporating the competencies prescribed by professional organizations, finding better ways to integrate genetic thinking into primary care NP education is imperative. A genetics clinical rotation has the potential to provide an educational taste that will lead to long-lasting improvements in primary care practice.

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